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We determined indices of plasma complement activation (C3, C4, Bb, C4d, iC3b, and SC5b-9), levels of tumor necrosis factor (TNF) and interleukin-6, and the APACHE II score in 23 patients with complicated Plasmodium falciparum malaria. On admission, plasma concentrations of Bb, SC5b-9, and C4d were markedly increased compared to healthy control subjects (n = 24) (4.5 +/- 1.9 vs 1.5 +/- 0.6 mg/L; 1125.7 +/- 496.9 vs 183.2 +/- 76.5 microg/L; and 15.7 +/- 5.7 vs 7.2 +/- 1.4 mg/L, P < 0.01 for all). In contrast C3 and iC3b concentrations were decreased (631.4 +/- 247 vs 947.3 +/- 243.2 and 105 +/- 17.9 vs 151.3 +/- 14.5 mg/L; P < 0.01 for both). Plasma C4 concentrations in malaria were not different from normal controls. Plasma Bb, C3, and iC3b levels normalized on day 7 of treatment, whereas SC5b-9 and C4d levels remained elevated. A significant correlation between elevated TNF levels and Bb (r = 0.507) and SC5b-9 (r = 0.448, P < 0.01 for both) and a negative correlation between iC3b and SC5b-9 and TNF levels existed (r = -0.537 and r = -0.466, P < 0.01 for both). In addition, a significant correlation between C3 and iC3b (r = 0.689) and C4 and C4d (r = 0.737) existed. However, no relation between clinical disease severity and complement fragments existed. The results demonstrate that both the classical and the alternative pathways of the complement system are profoundly activated in complicated malaria.
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
December 2007,
Malaria journal,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
September 2011,
Revista Brasileira de terapia intensiva,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
January 2009,
Malaria journal,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
November 2010,
Medicina intensiva,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
January 2013,
The Journal of infectious diseases,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
January 2000,
La Pediatria medica e chirurgica : Medical and surgical pediatrics,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
April 2012,
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
June 2008,
The Lancet. Infectious diseases,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
December 1998,
The American journal of tropical medicine and hygiene,
C Wenisch, and
S Spitzauer, and
K Florris-Linau, and
H Rumpold, and
S Vannaphan, and
B Parschalk, and
W Graninger, and
S Looareesuwan
January 1983,
Transactions of the Royal Society of Tropical Medicine and Hygiene,
